Organization
PROFESSIONAL PHARMACY RX, LLC
Active
Other names
Professional Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DARLA W CORLEY RPH (MANAGING MEMBER)
(318) 442-4485
Entity
Organization
Contact information
Practice address
1414 JACKSON ST, ALEXANDRIA, LA 71301-6931
(318) 442-4485
(318) 443-6410
Mailing address
1414 JACKSON ST, ALEXANDRIA, LA 71301-6931
(318) 442-4485
(318) 443-6410
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY.007236-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY.007236-IR
LOUISIANA BOARD OF PHARMACY LICENSE NUMBER
LA
Enumeration date
01/06/2016
Last updated
01/06/2016
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